Chen Dayong chuckled and said, "Who else should we hire if not him? The other doctor is even worse! He's just a bit better at it. At the city hospital, they only do a dozen or twenty joint replacement surgeries a year. How good can their skills be?"

Zhang Lei nodded. On average, there were only one or two machines a month, so even the director's hands would be very clumsy.

Li Zheng, standing aside, also nodded. Artificial hip replacement surgery was only introduced and performed in Longguo in the late 1970s. At that time, it was limited to a few hospitals in the imperial capital and the Magic City, and the joint prostheses were all imported.

Now it was the end of the 1980s and provincial hospitals had made good progress, but municipal hospitals had made relatively few progress and had not been doing so for long. It was considered fast that county hospitals were able to do so.

Nowadays, joint prostheses are all imported and are not cheap. If there are people who can make them in the county hospital, it probably must be because of various conditions. Otherwise, they would basically not choose to have the procedure done in the county hospital because they cannot go to the municipal or provincial hospital.

Soon, the anesthesia was completed.

Bao Youshan and Chen Dayong served as assistants.

Chen Dayong did not compete with Bao Youshan for help. After all, he had never performed this kind of surgery before. However, Bao Youshan had participated in knee joint surgery and was definitely more familiar with it.

Preoperative disinfection and draping were completed quickly.

Lin Xiaomei has also prepared the equipment.

"Director Zhang, you're here!" The circulating nurse opened the door and Director Zhang came in again with a cane.

"I've said before, as long as Li Zheng performs a new surgery, I will try my best to come. This is my only hobby!" Dean Zhang said with a smile.

Li Zheng and others greeted him one after another.

Director Zhang had no worries. He trusted Li Zheng unconditionally. Even if Li Zheng asked for a heart transplant, he would agree. It was just that the hospital didn't have the necessary hardware.

"Have you got the vascular clamp?" asked Director Zhang.

Lin Xiaomei moved the vascular clamp on the instrument table and said with a smile, "It's here!"

Dean Zhang nodded and smiled, "I brought this set of vascular clamps from the military hospital. I didn't think I'd ever need them, but I unexpectedly found them today. I hope I can use them more often in the future."

Everyone could hear the nostalgia for his past days as a doctor in Dean Zhang's words.

Chen Dayong reminded him, "Director, the vascular clamp was used in the spleen rupture surgery a few days ago!"

Dean Zhang suddenly realized and laughed, "Look at my memory. I have indeed used it before. Good, very good!"

"Inflate the tourniquet!" Li Zheng gave the order, and the circulating nurse squeezed the inflation ball hard to inflate the pneumatic tourniquet.

After two minutes of kneading, the air pressure was finally increased to 45 kPa. The nurse's hands were sore.

Seeing this scene, Li Zheng still missed the electric one in his previous life. It was fast and accurate, and the time could be set. It would automatically deflate at the appointed time to avoid limb ischemia, damage and necrosis caused by prolonged hemostasis.

These days, everything is very primitive.

The operation begins.

The patient was in a prone position, with the steel bar in the right popliteal fossa exposed about 10 centimeters outside the skin.

Now that the tourniquet has been applied, the steel bar can be removed.

"Wash again."

Li Zheng used gauze dipped in complex iodine to repeatedly wipe the part of the steel bar exposed outside the skin, and then rinsed it carefully with saline to wash away the rust as much as possible.

Li Zheng took the steel bar and pulled it. It could be pulled, but it was still a bit tight.

He had already seen the preoperative films and found that the steel bar did not pass through the femur, but came out from the front of the thigh along the lateral femoral condyle.

"Hold your thigh, I'm going to pull it out." Li Zheng said.

Bao Youshan and Chen Dayong pressed the thigh and calf respectively. Li Zheng grabbed the steel bar with both hands and pulled it out little by little. He did not rotate it, so as to minimize damage to the tissue, but this undoubtedly increased the difficulty of extraction.

It took a minute to pull it out completely.

"Big knife."

Lin Xiaomei handed it to Li Zheng.

With the hole in the steel bar as the center, Li Zheng extended the wound upward and downward, forming a large S shape, about 15 centimeters long.

Cut the skin, separate the subcutaneous tissue, and separate the intermuscular space along the perforation.

Dissect all the way to the surface of the joint capsule.

The tissue contamination was quite serious, so Li Zheng cleaned up all the contaminated tissue as much as possible to avoid postoperative infection.

The posterior popliteal vascular and nerve bundle was finally exposed.

Li Zheng carefully separated the blood vessels and nerves.

"How is the injury?" asked Director Zhang, who had no surgical field of view at all.

"The popliteal artery is ruptured three-quarters, with the damaged length approximately 2.8 cm. The popliteal vein is ruptured, with the damaged length approximately 2 cm. The tibial nerve is intact," Li Zheng said solemnly, breathing a sigh of relief. Although preoperative nerve function tests had shown no obvious signs of damage, seeing the confirmation with his own eyes was the only way to feel completely reassured.

If the tibial nerve is damaged, nerve transplantation will be extremely difficult. It's not that he doesn't have the ability to do it, but he needs to use a real high-power microscope. This kind of major nerve needs to have its fascicle sutured, just like a thick cable, and the small wires inside have to be sewn one by one, so that the motor and sensory functions can be restored as much as possible. The city hospital does not have this condition.

"hiss!"

Dean Zhang gasped and said, "The damage to the blood vessels is so severe that they can't be sutured directly!"

Although blood vessels have a certain degree of elasticity, if they are longer than 1 cm, forcible pulling and closing may easily cause blood vessel tearing and vascular spasm after surgery, thereby triggering vascular crisis.

Everyone looked at Li Zheng.

Blood vessel transplantation is something that no one dares to even think about.

Although domestic microsurgery technology began in the late 1960s and is a global leader, it is only available in the country's top tertiary hospitals. For inland county-level hospitals, it is still an unattainable technology.

This chapter is not over yet, please click on the next page to continue reading!